Selective centralized booking as a low-cost alternative to centralized referral

Area of Science:

• General Surgery
• Health Services Research

Background:

• Centralized referral systems can shorten surgical wait times but face sustainability challenges due to ongoing expenses.
• Inefficient scheduling and wait-list management contribute to prolonged surgical delays.

Purpose of the Study:

• To evaluate the effectiveness of a low-cost centralized booking project for hernia surgery.
• To assess the impact of centralized booking on surgical wait times and operating room utilization.

Main Methods:

• A prospective trial of a centralized booking system for hernia surgery was conducted from July to November 2019.
• Patients with inguinal or umbilical hernias were centrally booked with the first available surgeon post-consultation.
• Wait times were compared between centrally booked patients and those using the traditional system.

Main Results:

• Centralized booking reduced mean wait times for inguinal hernias from 137 to 82 days and for umbilical hernias from 181 to 80 days.
• The system increased operating room utilization by providing a larger patient pool for last-minute cancellations.
• Wait-lists were effectively equalized among six surgeons.

Conclusions:

• Selective centralized booking is a promising, low-cost strategy to improve access to general surgery.
• This model enhances operating room efficiency and significantly decreases patient wait times without requiring additional funding.